1. Anti-Coagulants Physical Process of Clotting
Chemical Process of Clotting
Fibrin formation, extrinsic and intrinsic pathways
Anti-coagulants
Definition
Heparin, Low molecular weight heparins, pentasaccharide
Structure, properties, biochemical mechanism
Coumarins and 1,3-indanediones
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MEDC 604 Anti-coagulants

2. A) Physical Process B) Chemical Process
The Clotting Process
A) Physical Process B) Chemical Process
Wound
antithrombins
factor Xa
thrombin prothrombin
fibrinogen
fibrin
(monomers)
(polymer)
vitamin K-dependent
g-carboxylation of
Glu residues
coumarins
platelet activation
release thrombin release of
of ADP generation thromboxane A2
Further activation of platelets
Platelet aggregation
aspirin
ADP
receptor
antagonists
GP IIb-IIIa
CLOT
Taken from Desai UR (2004) Med. Res. Rev. 24,
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MEDC 604 Anti-coagulants

3. Physical Process of Clotting
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MEDC 604 Anti-coagulants

4. Chemical Process of Clotting
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MEDC 604 Anti-coagulants

5. Heparin and Low molecular weight heparins
Structure and sequence
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MEDC 604 Anti-coagulants

6. Pentasaccharide
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7. Biochemical Mechanism of Heparin Action
AT + H
AT:H
AT-E H E
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MEDC 604 Anti-coagulants

8. Direct Thrombin Inhibitors
HIRUDIN – Isolated from leech, hirudino medicinalis. A polypeptide consisting of 65 amino acid residues that binds thrombin in the active site as well as another site called exosite I
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MEDC 604 Anti-coagulants

9. Coumarins and 1,3-indanediones
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10. Clinically useful coumarins and 1,3-indanediones
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11. Biochemical Mechanism of Action
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MEDC 604 Anti-coagulants